Nicholas Basham, PA in Fort Campbell, KY - Medicare Physician Assistant

Nicholas Basham, PA is a medicare enrolled "Physician Assistant" in Fort Campbell, Kentucky. His current practice location is 650 Joel Dr, Fort Campbell, Kentucky. You can reach out to his office (for appointments etc.) via phone at (270) 412-5122.

Nicholas Basham is licensed to practice in Tennessee (license number PA0000002721) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710301684.

Contact Information

	Nicholas Basham, PA
	650 Joel Dr, Fort Campbell, KY 42223-5318
	(270) 412-5122
	(270) 412-5168

Map and Direction

Provider's Profile

Full Name	Nicholas Basham
Gender	Male
Speciality	Physician Assistant
Location	650 Joel Dr, Fort Campbell, Kentucky
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1710301684
Provider Enumeration Date: 02/12/2014
Last Update Date: 04/25/2019

Medicare PECOS Information:

PECOS PAC ID: 1850517152
Enrollment ID: I20150416000578

Medical Identifiers

Medical identifiers for Nicholas Basham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710301684	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AS0400X	Physician Assistant - Surgical	(* (Not Available))	Secondary
363A00000X	Physician Assistant	PA0000002721 (Tennessee)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicholas Basham allows following entities to bill medicare on his behalf.

Entity Name	Riverside Spine & Physical Medicine, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720407570 PECOS PAC ID: 1456575141 Enrollment ID: O20140619002243

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas Basham is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nicholas Basham, PA 625 N Riverside Dr, Clarksville, TN 37040-3127 Ph: (931) 542-9420	Nicholas Basham, PA 650 Joel Dr, Fort Campbell, KY 42223-5318 Ph: (270) 412-5122

Reviews and Comments

Physician Assistant Nurses in Fort Campbell, KY

Terry A Thomas Jr, PA-S Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-956-0336
Christopher Alyn Peterson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-412-3535
Gregory Hershey, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 Phone: 270-798-8727 Fax: 270-956-0180
Matthew Bedinghaus, Physician Assistant Medicare: Medicare Enrolled Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8400
Mark Leon Siebe, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8727
Jessica Johns, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5979 Desert Storm Ave, Fort Campbell, KY 42223 Phone: 270-798-4677
Luke Alden Sward, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 650 Joel Dr, Fort Campbell, KY 42223 Phone: 270-798-8400

Nicholas Basham, PA - Medicare Physician Assistant in Fort Campbell, KY